If your child has just had a seizure with a fever, it is natural to feel frightened. Many parents feel as though their child was in serious danger.
The good news is that febrile seizures are common, and most are brief. Simple febrile seizures usually do not cause lasting harm. Still, a first seizure needs urgent medical evaluation, and not every seizure with a fever is a febrile seizure.
This guide explains what they are, what to do if one happens, and the warning signs that mean you should call 911.
What is a febrile seizure?
A febrile seizure is a seizure associated with fever in a young child, without a brain or spinal-cord infection or another cause explaining the seizure. A doctor assesses the child to make that distinction.
Having a febrile seizure does not by itself mean that your child has epilepsy.
- They usually happen between 6 months and 5 years old, most often around 12 to 18 months.
- About 2 to 5 out of every 100 children have at least one.
- Common childhood infections can trigger them. Occasionally, fever after a vaccination can trigger one; vaccines also prevent infections that can cause fever and seizures.
- Most are brief, whole-body stiffening-and-shaking episodes that stop on their own within a few minutes.
A seizure can happen early in an illness, before you even realize your child has a fever. It does not mean you failed to notice or treat the fever quickly enough.
What a febrile seizure looks like
During a seizure, a child may:
- Become stiff, then jerk or twitch the arms and legs
- Lose consciousness and not respond to you
- Roll the eyes back
- Have changes in breathing or color
Trouble breathing or blue or gray color is a reason to call 911—not something to simply watch at home.
Sleepiness or confusion can follow a seizure, but your child should gradually become more alert. Difficulty waking, abnormal breathing, or failure to recover needs emergency help.
What to do during a seizure
Try to stay calm. Most febrile seizures stop within a few minutes.
- Note the time the seizure starts. Use a clock or phone timer if available.
- Help your child onto a safe surface, such as the floor. Gently turn them onto their side with the mouth angled downward if you can do so safely, without forcing or restraining them.
- Clear away hard or sharp objects. Loosen tight clothing around the neck.
- Protect the head with something soft and flat, such as a folded jacket.
- Stay with your child. Watch their breathing and note which body parts move or whether the eyes or face turn to one side. Tell the medical team what you observed.
What not to do
- Do not put anything in the mouth—not fingers, spoons, medicine, food, or water. A child cannot swallow their tongue.
- Do not hold down or restrain the movements.
- Do not shake your child to try to wake them.
- Do not put your child in a bath or try to cool them rapidly during the seizure.
If your child already has a prescribed seizure-rescue medicine and a written plan, follow that plan. Do not give an unprescribed medicine or delay calling for help.
When to call 911 right away
Call 911 immediately if:
- This is your child's first-ever seizure.
- The seizure reaches 5 minutes. It may need emergency medicine to stop.
- Another seizure starts soon after the first, especially without recovery between them.
- Your child has trouble breathing, turns blue or gray, or does not resume normal breathing afterward.
- Your child cannot be awakened, remains unresponsive, or is not recovering as expected.
- Your child is injured during the seizure.
Do not drive a child who is still having a seizure or is unconscious. Call 911 and follow the dispatcher's instructions.
When urgent assessment is needed—even after the seizure stops
Get emergency medical evaluation for fever with a stiff neck, a bulging soft spot in a baby, a purple or bruise-like rash that does not fade with pressure, or a child who looks very ill.
These can be signs of a serious infection, including meningitis. Do not wait for a rash to appear, and do not use a rash that fades with pressure to rule out a serious infection. Call 911 if your child is difficult to wake, has breathing problems, or seems dangerously unwell.
A seizure affecting only one side of the body, a prolonged seizure, or more than one seizure in 24 hours also needs emergency assessment, even if your child seems better afterward.
Have any seizure with fever assessed promptly, particularly in a baby under 12 months. A seizure in a child younger than 6 months or outside the usual age range should not simply be assumed to be a typical febrile seizure.
Persistent vomiting, refusal to drink, or signs of dehydration also need prompt medical advice. The younger the child, the lower the threshold for having them checked.
After the seizure
- Stay nearby and let your child rest on their side while checking breathing and responsiveness.
- Some sleepiness is expected, but they should gradually become more alert. Do not assume that difficulty waking or worsening responsiveness is normal sleep.
- Wait until your child is fully awake and swallowing safely before offering any medicine, food, or drink by mouth.
- Once it is safe to give medicine, acetaminophen or ibuprofen may help fever-related discomfort when appropriate for age and weight. Ibuprofen is generally used from age 6 months unless the clinician advises otherwise.
- Have a doctor assess the cause of the fever and explain the follow-up plan.
Our Fever in Children guide includes weight-based dosing and medicine precautions.
Important things to know—and worry less about
- Brief, simple febrile seizures are not known to harm learning, intelligence, or development. Prolonged or unusual seizures need a different level of assessment, so the emergency warning signs still matter.
- Fever medicines do not reliably prevent febrile seizures. Use them for comfort, not to chase a normal temperature or guarantee that another seizure will not happen.
- They can happen again. Roughly 1 in 3 children has another febrile seizure, often during a later illness.
- Most children outgrow them. Most never develop epilepsy, although the later risk is somewhat higher than in children who have never had a febrile seizure.
Ask your pediatrician what to do if another seizure happens and whether your child needs a written plan. Knowing the steps can make a frightening situation more manageable.
A quick summary to keep on the fridge
- Stay calm and note the time.
- Gently turn your child onto their side if safe, clear the area, and protect the head.
- Nothing in the mouth. Do not restrain.
- Call 911 for a first seizure, a seizure reaching 5 minutes, another seizure soon afterward, breathing trouble, or difficulty waking.
- Stiff neck, a non-fading rash, or a very ill appearance needs emergency assessment.
- Wait until fully alert and swallowing safely before giving anything by mouth.
- Have a doctor check the cause of the fever and discuss a plan.